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World J Gastrointest Pharmacol Ther. Jun 5, 2026; 17(2): 121264
Published online Jun 5, 2026. doi: 10.4292/wjgpt.v17.i2.121264
Published online Jun 5, 2026. doi: 10.4292/wjgpt.v17.i2.121264
Fructose malabsorption associated with functional abdominal bloating: Case-control study
Arivarasan Kulandaivelu, Venkatesh Vaithiyam, Kartik Mehta, Ravi Teja Reddy, Aarushi Ahuja, Nikhil Sirohi, Ujjwal Sonika, Ashok Dalal, Ajay Kumar, Amarender Singh Puri, Sanjeev Sachdeva, Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi 110002, Delhi, India
Co-first authors: Arivarasan Kulandaivelu and Venkatesh Vaithiyam.
Author contributions: Kulandaivelu A, Vaithiyam V, and Sachdeva S contributed to conceptualisation, writing, reviewing, and editing; Mehta K, Vaithiyam V wrote the original draft; Puri AS, Vaithiyam V, Sirohi N, and Reddy RT participated in acquisition of data and drafting the manuscript; Sonika U, Dalal A, Kumar A, Ahuja A, and Mehta K participated in interpretation of data and critical revision of the data; Vaithiyam V and Sachdeva S did the final review of the manuscript, and all authors have read and approved the final version of the manuscript.
Institutional review board statement: The Institutional Ethics Committee of Maulana Azad Medical College and associated hospitals granted ethical approval (F. No. 11/IEC/MAMC/2011/206) and approved this study, which was conducted in accordance with the ethical guidelines of the 1975 Declaration of Helsinki.
Informed consent statement: All participants provided written informed consent before enrolment.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: All data related to the study are available from the corresponding author in the Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, and will be provided upon reasonable request.
Corresponding author: Sanjeev Sachdeva, Director, Head, Professor, Department of Gastro
Received: March 22, 2026
Revised: April 24, 2026
Accepted: May 11, 2026
Published online: June 5, 2026
Processing time: 68 Days and 22.2 Hours
Revised: April 24, 2026
Accepted: May 11, 2026
Published online: June 5, 2026
Processing time: 68 Days and 22.2 Hours
Core Tip
Core Tip: Fructose malabsorption (FM) is increasingly recognised as a contributor to functional gastrointestinal symptoms. In this case-control study, FM was significantly more common in patients with functional abdominal bloating than in healthy controls (29% vs 3%). A subset of patients with functional bloating who tested negative for the fructose hydrogen breath test (FHBT) had symptoms during the FHBT, suggesting a mechanism beyond fructose malabsorption, such as visceral hypersensitivity, in the pathogenesis of functional bloating. Female sex was identified as an independent predictor. These findings suggest that FM may be an important, potentially modifiable factor in patients presenting with functional bloating.